Varicella and Herpes Zoster Vaccines

Aetna covers varicella vaccination per ACIP recommendations (including MMRV/ProQuad as an alternative for children 12 months–12 years), varicella primary vaccination for specified HIV‑infected patients (age >8 with CD4 >200 cells/µL or children 1–8 with CD4% >15%), and recombinant zoster vaccine (Shingrix) as a two‑dose series to prevent herpes zoster in adults ≥50 years (including those previously given Zostavax). Aetna excludes booster Shingrix doses beyond the two‑dose series and deems Shingrix investigational for treatment of zoster/PHN or prevention of primary varicella, does not cover Zostavax (CPT 90736), and notes live varicella/zoster vaccines are contraindicated in immunodeficient/immunosuppressed persons, those with active untreated TB, and pregnant women.

"Zostavax (zoster vaccine live) was FDA-approved to reduce risk of herpes zoster in adults aged 60 years and older (historical FDA licensure for ages 50–59 noted; ACIP recommendation for routine use..."